Accounting and professional work in established NPM settings

Purpose: The paper problematizes previous research on accountingisation, where the role of accounting in determining the scope of professional work is understood in relation to a professional/economic dichotomy and a model of episodic change. The purpose of this paper is to investigate everyday professional work in established new public management (NPM) settings, and proposes a new conceptual framework to analyze the role of accounting therein. The aim is to enable future investigations into how, when and where a situated “bottom line” emerges, by conceptualizing professional work as a process of calculation. Design/methodology/approach: Qualitative data from case studies of two tertiary level geriatric organizations using observations of 33 employees and four interviews. Data related to patient discharge, and the management of the discharge processes, were analyzed. Findings: Few visible trade-offs between distinctly professional or economic considerations were observed. Rather, the qualification of patients’ status and evaluation of their dischargeability centered on debates over treatment time. Time therefore operated as a situated “bottom line,” to which various other concerns were emergently linked in a process of calculation. Professional practitioners seldom explicitly evoke accounting concepts and technologies, but these were implicated in the ongoing translation of each patient into something temporarily stable, calculable and thus actionable for the professionals involved in their care. The study’s findings have implications for the conceptual understanding of professional work in established NPM settings. Research limitations/implications: Case study research is context-specific and the role of accounting in professional work will vary due to the professional groups and accounting technologies involved. Practical implications: The study’s findings have implications for how to influence professional behavior through interventions in the existing landscape of accounting technologies. The possibility to change behavior through the introduction or removal of individual accounting technologies is questioned. Originality/value: To date, research on the role of accounting in determining the scope of professional work has assumed a professional/economic dichotomy and studied episodic change linked to accounting-oriented reforms. This paper analyses the role of accounting as an on-going process with emergent boundaries between professional and economic considerations.